Everything to Know About Hematoma: Types, Causes, and More

Medically Reviewed By Stacy Sampson, D.O.
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A hematoma is a pocket of blood inside the body caused by hemorrhage, rapid blood loss. A hematoma forms when a blood vessel ruptures or leaks blood into the surrounding tissue or body cavity. A hematoma can occur anywhere in the body. This includes the brain.

The majority of hematomas go away on their own without medical treatment. However, in some cases, you may require surgery.

Read on to learn about the types of hematomas and what causes them. This guide also discusses symptoms, treatments, when to contact a doctor, and more.

What causes a hematoma?

There is a closeup of a person with a bandage on their knee.
helivideo/Getty Images

A hematoma occurs following injury to a blood vessel. This causes blood to pool or collect outside of the vessel.

Possible causes or risk factors for hematomas include:

  • bone fractures, which can result in tearing or leaking from surrounding blood vessels
  • venipuncture
  • anticoagulation medications, such as warfarin
  • arterial puncture

Surgery can also cause damage to blood vessels. This in turn can lead to a hematoma.

What are the types of hematoma?

There are different types of hematoma. These include:

  • subcutaneous hematoma
  • intramuscular hematoma
  • subungual hematoma
  • auricular hematoma
  • nasal septal hematoma
  • abdominal hematoma
  • pelvic hematoma
  • subchorionic hematoma
  • intracranial hematoma

Subcutaneous hematoma

“Subcutaneous” means beneath the skin. A subcutaneous hematoma is one that occurs underneath the skin.

Muscular hematoma

Muscular hematomas occur when blood from vessels pools in the muscle groups. Muscular hematomas most commonly occur in the abdominal waist.

Subungual hematoma

Subungual hematomas occur beneath the fingernail or toenail. The usual cause is injury to the finger or toe, which results in discoloration as blood collects beneath the nail.

Auricular hematoma

An auricular hematoma affects the ear. It occurs when blood collects underneath the perichondrium, which is connective tissue in the ear. Auricular hematoma is the cause of “cauliflower ear.”

Nasal septal hematoma

Nasal septal hematomas occur when blood collects beneath the mucous membranes of the nasal septum cartilage and bone. A nasal septal hematoma is a rare but serious complication of facial injury.

Abdominal hematoma

Abdominal hematomas can occur in the abdominal cavity or in the muscles or tissues of the abdominal wall.

Specifically, a rectus sheath hematoma is a result of bleeding in the rectus abdominis and pyramidalis muscles inside the sheath.

Pelvic hematoma

Pelvic hematomas occur from damage to the pelvic organs. Bleeding from a pelvic fracture can be fatal.

Subchorionic hematoma

Subchorionic hematomas occur beneath the chorion membranes. The chorion membranes enclose the embryo inside the uterus.

Subchorionoic hematoma and subchorionic hemorrhage are the most common causes of vaginal bleeding during pregnancy weeks 10–20, accounting for about 11% of cases.

Intracranial hematoma

Intracranial hematomas occur inside the skull or brain. There are four main types of intracranial hemorrhage or hematoma.

  • Epidural hematoma: This occurs between the dura mater, the outer layer of the membranes surrounding the brain, and the skull. Skull fracture causes 85–95% of cases.
  • Subdural hematoma: This occurs underneath the dura mater. Subdural hematoma can occur spontaneously or result from head trauma, coagulopathy, or a rupture in the veins. Learn more about subdural hematoma.
  • Subarachnoid hemorrhage: This occurs on the pia mater meningeal layer that covers the surface of the brain beneath the arachnoid layer of the meninges. Subarachnoid hemorrhage most commonly occurs after trauma to the cortical surface vessels.
  • Intracerebral or intraparenchymal hemorrhage: This is a blood pocket in the brain tissue itself. It most commonly occurs as a result of high blood pressure causing damage to cerebral blood vessels.

What does a hematoma look like?

View the slideshow below for hematoma pictures.

hematoma-on-the-leg-body1.jpg

This shows hematoma on the leg.

Giada Canu/Stocksy United

hematoma-on-the-cheek-body2.jpg

This shows hematoma on the cheek.

Casa nayafana/Shutterstock

hematoma-under-a-fingernail-body4.jpg

This shows subungual hematoma beneath the fingernail.

Callaleo, CC BY-SA 4.0, via Wikimedia Commons

hematoma-under-a-toenail-body3jpg.jpg

This shows subungual hematoma beneath the toenail.

AllMyRoots/Shutterstock

Hematoma vs. bruise: What is the difference?

A hematoma occurs when there is damage to a blood vessel, causing blood to collect outside of the vessel.

A bruise is bleeding under the skin. Following an injury, superficial blood vessels break, causing the bleeding. If the skin does not break, blood remains inside. This causes the discoloration of a bruise.

Find out more about the difference between hematomas and bruises.

Hematoma vs. hemorrhage: What is the difference?

Broken blood vessels cause both hematoma and hemorrhage.

Hematoma refers to blood that pools outside of the blood vessel. Hemorrhage involves acute blood loss. A hematoma can occur as a result of hemorrhaging.

Learn about cerebral hemorrhage, a type of bleeding in the brain.

What are the symptoms of a hematoma?

Symptoms of a hematoma depend on the location and severity of the injury, and include:

  • bruising
  • swelling
  • pressure
  • skin discoloration
  • headache
  • seizure, with a subdural hematoma
  • loss of bowel or bladder control, with an epidural hematoma
  • abdominal pain, if the hematoma affects your peritoneum, liver, or spleen
  • lethargy or confusion, with an intracranial hematoma

Symptoms such as swelling and bleeding may develop slowly.

Contact your doctor if you have symptoms of a hematoma. While hematomas are not always a cause for concern, there may be damage to deeper tissues and blood vessels.

Find out more about symptoms of internal bleeding.

What are the treatments for a hematoma?

Most hematomas are small and may heal on their own. Bleeding may stop spontaneously and may not require treatment.

For certain hematomas, such as subungual hematomas, treatments can include over-the-counter pain medication and RICE. RICE stands for “rest, ice, compression, and elevation.”

Your doctor may also advise that you stop taking anticoagulation medication. However, continue to take any prescription medications unless your doctor recommends that you stop or change them.

Surgical procedures

In severe cases, such as a significant intracranial hematoma, surgery is usually necessary. Possible procedures include:

Before surgery, your doctor and surgeon will discuss options and risks of the procedure with you.

When should I contact a doctor?

Contact your doctor as soon as you have concerns about hematoma.

A hematoma can go away on its own. However, it is important to know if there is damage to deep tissues or blood vessels.

You should also contact your doctor if bleeding does not stop or if the area causes you pain.

How is a hematoma diagnosed?

To help with a diagnosis, your doctor may ask you questions such as:

  • When did you first notice the hematoma?
  • Do you know what caused the hematoma?
  • Have you had a previous hematoma?
  • Do you have a history of blood clotting problems?
  • Do you have other symptoms?
  • Are you taking blood thinning medication?

In some cases, your doctor may be able to diagnose hematoma with a physical examination. However, they may order tests to confirm the diagnosis.

Depending on the cause or location of the hematoma, tests may include:

What are the risk factors for hematoma?

A number of factors increase your risk of developing a hematoma, including:

What are the complications of a hematoma?

Complications depend on location and severity, and include:

Complications of a hematoma can be serious and lead to death. Contact your doctor as soon as you have concerns about hematoma to reduce your risk of complications.

Frequently asked questions

Here are questions people also ask about hematoma.

Is a hematoma serious?

Hematomas can be serious. While many can heal on their own, hematomas such as those affecting the brain require immediate medical attention.

How long does a hematoma take to heal?

Healing time will vary depending on the individual and the type of hematoma. For example, subdural hematoma may take several weeks or months to heal. Pain from subungual hematoma may resolve within days. Your doctor will be able to advise you about expected recovery times for a specific hematoma.

Summary

A hematoma occurs when a blood vessel ruptures and blood collects in the area. This can happen anywhere in the body.

Many hematomas heal without medical treatment, but some require surgery. Contact your doctor as soon as you experience symptoms of a hematoma.

A hematoma can be serious if it occurs in the skull cavity or involves deep tissues. Surgery is possible to drain the blood and reduce the risk of complications.

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Medical Reviewer: Stacy Sampson, D.O.
Last Review Date: 2022 Aug 18
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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